Changewave Research: Genetic Testing and Preventative Health Care

ChangeWave Research: Genetic Testing and Preventative Health Care

ChangeWave Research Report:

Genetic Testing and Preventative Health Care

Overview

A recent ChangeWave survey of 322 doctors focused on the latest trends in genetic testing andpreventative health care. The survey was conducted during the week of January 21 – 26, 2009.

Rise in Genetic Testing Referrals

Nearly a third of doctors (30%) nowsay they’verecommended or referred patients fora genetic test to asses risk for a specific disease over the past 12 months – an increase of 5-pts since our previous July 2008 survey.Cancer Risk(34%) was the top reason why.

The ChangeWave survey also shows increasing demand for genetic testing. Better than one-in-five doctors (21%) report they’reMore Likely to recommend or refer patients for genetic testing over the next 12 months, while only 3% say they’re Less Likely.

The Big Market Driver – Genetic Testing for Specific Diseases

An overwhelming majority of doctors who have received inquiries about genetic testing say it’s because ofpatient concern overRisk For Developing a Specific Disease (85%).Another 13% say it’s because of General Health Concerns.

We then asked doctorsabout severalspecific medical conditions, including Alzheimer’s, Asthma, Cancer, Diabetes, Heart Disease, Multiple Sclerosis, and Parkinson’s.

The following chart shows the percentage of doctors who report their patients are Veryor Somewhat Concerned with developing each condition – along with the change since our July survey.

Cancer (92%) is still the disease patients are most concerned with, but Heart Disease (90%) and Diabetes (85%) show the biggest increase since our previous survey – up 7-pts and 6-pts respectively.

We also note that a huge percentage of doctors say they're willing to refer patients for specific tests like Cancer (82%; down 3-pts), Diabetes (73%; down 5-pts) and Heart Disease (72%; down 8-pts), although down slightly from the previous survey.

Doctor Opinions on Genetic Testing

We asked our doctor panel a series of true/false questions about genetic testing to gauge their opinionson a range of important issues.

Better than half of doctors surveyed (53%) agree thatinformation gained from genetic testing would help the overall wellness of patients at their practice.

But despite their belief that genetic testing is important and can help their patients, doctors still show significant hesitation and are strong advocates of regulatory controls over this nascent industry.

• Four-in-five doctors (80%) favor regulatory approval before genetic tests become available to consumers.

• Nearly three-in-five (58%) say patients should be required to have a doctor's permission before getting expensive genetic testing.

• Just one-in-four (24%) believe the genetic tests available today are highly accurate and predictive.

• Only 22% say genetic testing companies should be allowed to market their services directly to consumers.

• Perhaps most importantly, only one-in-ten doctors (11%)currently think genetic testing has become an integral part of their practice.

Genetic Testing Companies

We asked doctors about several companies that conduct genetic-based tests for individuals. Genzyme (GENZ)ranks as the one they’re most familiar with(15% Very Familiar; 29% Somewhat Familiar). Genzyme offers a variety of services – including reproductive/genetics testing and oncology/pathology screening – foreverything from rare conditions like Gaucher’s disease to breast and colorectal cancer.

Myriad Genetics (MYGN) ranked secondin the survey, with 8% of doctors saying they were Very Familiar; and 29% Somewhat Familiar with their services. Myriad also offers testing for breast cancer, as well as ovarian, skin, and colon cancer.

A Look At Preventative CareTrends

While genetic testing helps identifythe risk for developing specific diseases,preventative care involves taking pre-emptive action. Here’s what our doctors respondents reportabout preventative caretrends in their practice:

Better than two-in-five doctors (42%) see an increase in patient interest inpreventative care and wellness compared to a year ago, while just 6% say there has been a decrease in interest. However, that’s down a net 9-pts since our July 2008 survey.

In a trend that may be anindirect side effect of the increased stress from the economic recession, there is a downturn in the percentage of doctors who say patients are more frequently trying to Quit Smoking/Tobacco (+31; down 5-pts).

On the upside, doctors believe patients are Exercising (+37; up 4-pts) more often than they did a year ago.

Nutraceuticals. We also asked doctors about several companies in the nutraceutical market, and found that Whole Foods (WFMI; 60%) had by far the highest rate of familiarity in this market. Schiff Nutrition (WNI; 26%) is second followed by USANA Health Sciences (USNA; 20%) and Nutraceutical Intl. (NUTR; 19%).

Among doctors familiar with their products,Whole Foods (WFMI; +47) has the most positive image – with 50% saying they have a Favorable view of the company’s nutraceutical products,and only 2% Unfavorable. Schiff Nutrition (WNI; +30) ranks second.

Bottom Line: The current findings show arise indoctor referrals for genetic testing going forward. We also note that a huge percentage of doctors say they're willing to refer patients for specific tests like Cancer, Diabetes and Heart Disease, although this is down slightly from the previous survey.

Despite their overall belief that genetic testing is important and can help their patients, doctors still show a significant degree of hesitation and are strong advocates of regulatory controls over the nascent industry. Importantly, only one-in-ten doctors currently agree that genetic testing has become an integral part of their practice.

Summary of Key Findings

Presriptions

The ChangeWave Allianceis a group of 20,000 highly qualified business, technology, and medical professionals in leading companies of select industries—credentialed professionals who spend their everyday lives working on the frontline of technological change. ChangeWave surveys its Alliance members on a range of business and investment research and intelligence topics, collects feedback from them electronically, and converts the information into proprietary quantitative and qualitative reports.

Helping You Profit From A Rapidly Changing World ™

Table of Contents

Summary of Key Findings...... 2

The Findings...... 6

(A) Genetic Testing...... 6

(B)A Look At Preventative Care Trends...... 13

ChangeWave Research Methodology...... 21

About ChangeWave Research...... 21

I. The Findings

Introduction

A recent ChangeWave survey of 322 doctors focused on the latest trends in genetic testing and preventative health care. The survey was conducted during the week of January 21 – 26, 2009.

(A) Genetic Testing

Question Asked: In the past 12 months, have you or anyone at your practice/clinical environment recommended or referred a patient to have genetic testing to assess risk for a specific disease?

Current
Survey
Jan ‘09 / Previous
Survey
July ‘08
Yes / 30% / 25%
No / 70% / 74%

Rise in Genetic Testing Referrals – Past 12 Months. Nearly a third of doctors (30%) now say they’ve recommended or referred patients for a genetic test to asses risk for a specific disease over the past 12 months – an increase of 5-pts since our previous July 2008 survey.

Question Asked: If Yes, Why? (n=80)

Current
Survey
Jan ‘09
Cancer Risk / 34%
Prenatal/Fertility Screening / 10%
Cardiomyopathy/Cardiovascular Disease / 5%
Cystic Fibrosis / 5%
Marfan’s Disease / 4%
Hearing Loss / 3%
Alzheimers / 3%
Other / 38%

Cancer Risk (34%) was the top reason why, followed by Prenatal/Fertility Screening (10%).

Question Asked: And over the next 12 months, are you or your practice more likely to recommend/refer patients to have genetic testing, less likely, or has there been no change compared to the previous 12 months?

Current
Survey
Jan ‘09
More Likely Over Next 12 Months / 21%
Less Likely Over Next 12 Months / 3%
No Change / 65%
Don't Know / 10%

Demand Increasing – Next 12 Months. The ChangeWave survey also shows increasing demand for genetic testing. Better than one-in-five doctors (21%) report they’re More Likely to recommend or refer patients for genetic testing over the next 12 months, while only 3% say they’re Less Likely.

Question Asked: How would you rate patient interest in genetic testing at your practice/clinical environment? Would you say patients are more interested in genetic testing than they were a year ago, less interested, or has there been no change?

Current
Survey
Jan ‘09
More Interested Than a Year Ago / 24%
Less Interested Than a Year Ago / 3%
No Change / 56%
Don't Know / 13%

More Patient Interest in Genetic Testing.One-in-four doctors (24%) say patients are More Interested in genetic testing than they were a year ago, compared with only 3% who sayLess Interested.

The Big Market Driver – Genetic Testing for Specific Medical Conditions

Question Asked: When patients ask about genetic testing, is it more often in reference to their risk for developing a specific disease, or is it in reference to general health concerns?

Current
Survey
Jan ‘09 / Previous
Survey
July ‘08
Risk For Developing a Specific Disease / 85% / 75%
General Health Concerns / 13% / 21%
Other / 2% / 3%

An overwhelming majority of doctors who have received inquiries about genetic testing say it’s because of patient concern over Risk For Developing a Specific Disease (85%). Another 13% say it’s because of General Health Concerns.

We then asked doctors about several specific medical conditions, including Alzheimer’s, Asthma, Cancer, Diabetes, Heart Disease, Multiple Sclerosis, and Parkinson’s.

The following chart shows the percentage of doctors who report their patients are Very or Somewhat Concerned with developing each condition – along with the change since our July survey.

Patient Concerns.Cancer (92%) is still the disease patients are most concerned with, but Heart Disease (90%) and Diabetes (85%) show the biggest increase since our previous survey – up 7-pts and 6-pts respectively.

Question Asked: Within your practice, how concerned would you say patients are about developing each of the following conditions?

Current Survey January 2009

Very
Concerned / Somewhat
Concerned / Not Very
Concerned / Not
Concerned
At All / No
Answer
Cancer (Any Type) / 59% / 33% / 4% / 1% / 3%
Heart Disease / 43% / 47% / 7% / 1% / 3%
Alzheimer's Disease / 39% / 43% / 10% / 6% / 2%
Diabetes / 30% / 55% / 10% / 2% / 3%
Parkinson's Disease / 10% / 31% / 43% / 13% / 3%
Asthma / 8% / 31% / 50% / 7% / 3%
Multiple Sclerosis / 7% / 23% / 48% / 20% / 3%

Previous Survey July 2008

Very
Concerned / Somewhat
Concerned / Not Very
Concerned / Not
Concerned
At All / No
Answer
Cancer (Any Type) / 57% / 34% / 4% / 0% / 5%
Heart Disease / 41% / 42% / 10% / 1% / 6%
Alzheimer's Disease / 39% / 38% / 13% / 4% / 6%
Diabetes / 28% / 51% / 14% / 0% / 7%
Asthma / 7% / 29% / 43% / 15% / 7%
Parkinson's Disease / 6% / 29% / 43% / 15% / 7%
Multiple Sclerosis / 4% / 22% / 49% / 19% / 6%

Doctor Opinions on Genetic Testing

We asked our doctor panel a series of true/false questions about genetic testing to gauge their opinionson a range of important issues.

Question Asked: True or False: Please answer true or false for each of the following statements about genetic testing.

True / False / No
Answer
Information gained from genetic testing would help the overall wellness of patients at my practice. / 53% / 44% / 2%
Genetic testing has become an integral part of my practice. / 11% / 86% / 3%
Genetic tests provide much more information than traditional approaches such as blood tests, physical exams and family history screening. / 28% / 69% / 2%
Genetic testing companies should be allowed to market directly to consumers. / 22% / 76% / 2%
If regulations were passed requiring a doctor's approval to get genetic testing, my practice would be more likely to recommend genetic testing to patients. / 45% / 53% / 2%
Genetic tests should be subjected to a regulatory approval process before becoming available to consumers. / 80% / 18% / 2%
The Genetic tests available today are highly accurate and predictive. / 24% / 71% / 6%
Patients should be required to have a doctor's permission before getting expensive genetic testing / 58% / 39% / 2%
Health Insurance providers should be required to pay for genetic testing only when recommended by a doctor. / 76% / 22% / 2%
Someone at my practice has been contacted by a Genetics testing company about the products and/or services they offer / 17% / 80% / 2%

Previous Survey July ‘08

True / False / No
Answer
Information gained from genetic testing would help the overall wellness of patients at my practice. / 62% / 35% / 3%
Genetic testing has become an integral part of my practice. / 12% / 86% / 3%
Genetic tests provide much more information than traditional approaches such as blood tests, physical exams and family history screening. / 32% / 65% / 3%
Genetic testing companies should be allowed to market directly to consumers. / 27% / 70% / 3%
If regulations were passed requiring a doctor's approval to get genetic testing, my practice would be more likely to recommend genetic testing to patients. / 50% / 47% / 3%
Genetic tests should be subjected to a regulatory approval process before becoming available to consumers. / 76% / 21% / 3%
The Genetic tests available today are highly accurate and predictive. / 26% / 66% / 8%
Patients should be required to have a doctor's permission before getting expensive genetic testing / 55% / 41% / 4%
Health Insurance providers should be required to pay for genetic testing only when recommended by a doctor. / 80% / 17% / 3%
Someone at my practice has been contacted by a Genetics testing company about the products and/or services they offer / 17% / 80% / 3%

Better than half of doctors surveyed (53%) agree thatinformation gained from genetic testing would help the overall wellness of patients at their practice.

But despite their belief that genetic testing is important and can help their patients, doctors still show significant hesitation and are strong advocates of regulatory controls over this nascent industry.

• Four-in-five doctors (80%) favor regulatory approval before genetic tests become available to consumers.

• Nearly three-in-five (58%) say patients should be required to have a doctor's permission before getting expensive genetic testing.

• Just one-in-four (24%) believe the genetic tests available today are highly accurate and predictive.

• Only 22% say genetic testing companies should be allowed to market their services directly to consumers.

• Perhaps most importantly, only one-in-ten doctors (11%)currently think genetic testing has become an integral part of their practice.

We also asked doctors about their willingness to refer patients for genetic testing.

Question Asked: Genetic testing is currently being used to assess the risk of developing a wide range of medical conditions. For each of the following medical conditions, please indicate how willing you would be to refer an interested patient to have a genetic test to determine their risk for developing the condition.

Current Survey January ‘08

Very
Willing / Somewhat
Willing / Not Very
Willing / Not
At All
Willing / No
Answer
Cancer (Any Type) / 49% / 33% / 9% / 6% / 3%
Heart Disease / 38% / 34% / 16% / 8% / 5%
Diabetes / 35% / 38% / 16% / 7% / 4%
Alzheimer's Disease / 32% / 37% / 18% / 10% / 3%
Parkinson's Disease / 29% / 35% / 21% / 11% / 3%
Multiple Sclerosis / 26% / 35% / 24% / 11% / 4%
Asthma / 16% / 38% / 28% / 14% / 4%

Previous Survey July ‘08

Very
Willing / Somewhat
Willing / Not Very
Willing / Not
At All
Willing / No
Answer
Cancer (Any Type) / 56% / 29% / 7% / 3% / 4%
Heart Disease / 49% / 31% / 10% / 5% / 4%
Diabetes / 45% / 33% / 11% / 5% / 6%
Alzheimer's Disease / 36% / 34% / 19% / 6% / 4%
Parkinson's Disease / 28% / 36% / 23% / 6% / 7%
Multiple Sclerosis / 29% / 38% / 22% / 7% / 5%
Asthma / 20% / 37% / 29% / 8% / 6%

Doctor Willingness To Refer Patients. We note that a huge percentage of doctors say they're willing to refer patients for specific tests like Cancer (82%; down 3-pts), Diabetes (73%; down 5-pts) and Heart Disease (72%; down 8-pts), although down slightly from the previous survey.

Question Asked: The following is a list of companies that conduct genetic tests for individuals. How familiar are you with each of the following personal genomics companies?

Very
Familiar / Somewhat
Familiar / Know the
Name Only / Never Heard
of This
Company/NA
Genzyme / 15% / 29% / 34% / 22%
Myriad Genetics / 8% / 14% / 17% / 60%
23andMe / 2% / 4% / 7% / 87%
deCode Genetics / 2% / 6% / 11% / 80%
DNA Direct / 2% / 7% / 16% / 75%
Genova Diagnostics / 2% / 6% / 21% / 71%
Compugen / 1% / 3% / 12% / 84%
GeneLink / 1% / 4% / 16% / 79%
Navigenics / 1% / 3% / 10% / 87%
Knome / 0% / 2% / 6% / 91%
Sciona / 0% / 3% / 5% / 92%

Genetic Testing Companies. We asked doctors about several companies that conduct genetic-based tests for individuals. Genzyme (GENZ)ranks as the one they’re most familiar with(15% Very Familiar; 29% Somewhat Familiar). Genzyme offers a variety of services – including reproductive/genetics testing and oncology/pathology screening – for everything from rare conditions like Gaucher’s disease to breast and colorectal cancer.

Myriad Genetics (MYGN) ranked second in the survey, with 8% of doctors saying they were Very Familiar; and 29% Somewhat Familiar with their services. Myriad also offers testing for breast cancer, as well as ovarian, skin, and colon cancer.

(B) A Look At Preventative Care Trends

While genetic testing helps identify the risk for developing specific diseases, preventative care involves taking pre-emptive action. Here’s what our doctors respondents report about preventative care trends in their practice:

Question Asked: Within your own practice or clinical environment, have you noticed an increase in patient interest for preventative care/wellness, a decrease, or has there been no change compared to a year ago?

Current
Survey
Jan ‘09 / Previous
Survey
July ‘08
Increase / 42% / 48%
Decrease / 6% / 3%
No Change / 50% / 48%
Don't Know / 2% / 1%

Patient Interest in Preventative Care. Better than two-in-five doctors (42%) report an increase in patient interest in preventative care and wellness compared to a year ago, while just 6% say there has been a decrease in interest. However, that’s down a net 9-pts since our July 2008 survey.

Question Asked: For those who have noticed an increase, which specific areas of preventative care/wellness have patients been asking more about?(Check All That Apply)(n=136)

Current
Survey
Jan ‘09 / Previous
Survey
July ‘08
Weight Loss Programs / 68% / 64%
Exercise / 62% / 52%
Vitamin/Nutritional Supplements / 59% / 63%
Smoking Cessation / 51% / 46%
Cancer Prevention / 40% / NA
Herbal Supplements / 38% / 39%
Other Disease Prevention* / 22% / 52%
Other / 8% / 7%

* In the previous July ’08 survey this response choice was Disease Prevention.